P-061 - Immunocytochemical method for diagnosis of metastases of signet ring cell carcinoma of the stomach

Abstract

Introduction: Evaluation of the informative value of the cytological method in the diagnosis of metastasis of cricoid-cell carcinoma of the stomach in ascites and pleural fluid. Methods: The results of cytological diagnostics of patients with cricoid carcinoma of the stomach of 24 patients in ascitic fluid and of 10 patients in pleural fluid were evaluated. They were treated on the basis of the Department of Oncology and Radiology of the Tashkent Medical Academy. A method of light microscopy with staining of Pappenheim drugs and an immunocytochemical method using a liquid preparation method were used, using standard techniques carrying out immunocytochemical reactions. The results of the study were evaluated and compared with the final diagnosis. Results: The patients' age was 48.5 ± 6.9 years, there were 16 men, 18 women. In 25 patients operated on for stomach cancer, ascites and pleurisy appeared 1-9 years. In the ascitic fluid of 9 patients, malignant tumor cells were detected during a primary examination. Without additional techniques, cricoid carcinoma in the fluid by the cytological method was established in 9 patients (26.5%). In the preparations, tumor cells with eccentrically located nuclei were noted, the individual cells took the form of a ring with a deformed nucleus and a vacuole with a mucus occupying almost the entire cellular body. Expression of EMA expression in the cytoplasm of tumor cells was noted in 61.5% (positive cases (in all cases, 8/13), Ber-EP4 in 100% (17/17), Claudin in 100% (4/4), CDX-2 in 35.3% (6/17), p53 in 100% (5/5), Ki-67 in 100% (3/3). Expression of cytokeratins was as follows: SC AE1/AE3 (13/13, 100%), SC MNF116 (13/13, 100%), CK5/6 (1/13, 7.7%), CK7 (15/17, 88, 2%), CK18 (17/17, 100%) and CK20 (8/17, 47.1%). In differential diagnosis of tumor cells and histiocytes, studies on CEAmono and CEApoly, which were 100% (15/15), were most significant, staining was pronounced. A positive reaction was noted in cells that were perceived as lightning microscopy as histiocytes. In histiocytes and leukocytes present in the liquid, a positive reaction to CD45 and CD68 was observed in the immunocytochemical study. Conclusion: 1) the possibility of light microscopy for diagnosis of metastasis of cricoid carcinoma in ascites and pleural fluid was 26.5%, which dictates the need to use additional refinement techniques; 2) the immunocytochemical method allows to confirm the histogenesis of tumor cells, however, antibodies specific for cricoid-cell carcinoma were not detected; 3) the problem of differential diagnosis of histiocytes, cellular mesothelium cells and cellular tumor cells is easily solved using an immunocytochemical reaction to cancer embryonic and epithelial antigens, which allows affirmatively determining the affiliation of cells to the cricoid-cell carcinoma.